title: Gonadotropin-releasing hormone analogue plus hormone replacement therapy for the treatment of endometriosis: a randomized controlled trial.
abstract: OBJECTIVE
  The aim of this study was to determine whether or not continuous combined HRT used with GnRH-a for the treatment of endometriosis can prevent hypoestrogenic side effects associated with GnRH-a.
  
  
  METHODS
  Forty premenopausal women with laparoscopically proven endometriosis entered the study. The patients were randomized into two groups. Group I (n = 19) received 3.75 mg i.m. leuprolide acetate (LA) every 4 weeks for 24 weeks. Group II (n = 21) received 3.7 mg LA combined with 1.25 mg oral conjugated equine estrogen (CEE) and 5 mg oral medroxyprogesterone acetate (MA).
  
  
  RESULTS
  Total revised AFS score as well as total pelvic pain scores decreased significantly (P < .001) in both groups. However, a statistically significant difference of hot flushes and sweating was reported by women receiving LA + HRT as compared to those treated with LA alone (P < .001). Furthermore, the bone loss at the lumbar spine was 4.2% in group I compared to 0.9% in group II at the end of the study.
  
  
  CONCLUSIONS
  This study suggests that 1.25 mg CEE + 5 mg MA is effective in preventing hypoestrogenic side effects caused by GnRH-a, while the treatment of endometriosis is not impaired.
authors.affiliation: 2nd Department of Obstetrics and Gynecology, University of Athens, Areteion Hospital, Greece.
authors.forename: O
authors.initials: O
authors.lastname: Gregoriou
authors.forename: S
authors.initials: S
authors.lastname: Konidaris
authors.forename: N
authors.initials: N
authors.lastname: Vitoratos
authors.forename: C
authors.initials: C
authors.lastname: Papadias
authors.forename: I
authors.initials: I
authors.lastname: Papoulias
authors.forename: A
authors.initials: A
authors.lastname: Chryssicopoulos
mesh_terms: D000328:Adult; D015519:Bone Density / Q000187:drug effects* / Q000502:physiology; D015331:Cohort Studies; D004359:Drug Therapy, Combination; D004715:Endometriosis / Q000097:blood / Q000188:drug therapy*; D004958:Estradiol / Q000097:blood / Q000378:metabolism; D015914:Estrogen Replacement Therapy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood / Q000378:metabolism; D019584:Hot Flashes / Q000139:chemically induced; D006801:Humans; D007273:Injections, Intramuscular; D016729:Leuprolide / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D007986:Luteinizing Hormone / Q000097:blood / Q000187:drug effects / Q000378:metabolism; D015663:Osteoporosis, Postmenopausal / Q000139:chemically induced*; D017699:Pelvic Pain / Q000188:drug therapy; D011446:Prospective Studies; D013546:Sweating / Q000187:drug effects; D013997:Time Factors
chemical_list: D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D016729:Leuprolide